158 kidneys, 9 from living related donors and 149 from cadavers, have been transplanted in the first 42 months of the establishment of a transplant unit at Oxford. Patients' ages ranged from 11 to 56 (mean 35) years. Azathioprine and prednisolone alone were used for immunosuppression, and a minimum-transfusion policy was in operation throughout. After cadaveric transplantation actuarial patient-survival is 70% and 68%, respectively, at the same intervals. 85% of patients who had a functioning graft are fully rehabilitated. Matching for HLA-DR, pregraft blood-transfusions, and the finding that a transplant could be performed in the presence of a positive B-cell crossmatch have proved to be the most significant of the many factors examined both prospectively and retrospectively. The function of the unit is based on dialysis and transplantation for all patients in end-stage renal failure, with transplantation being considered the first line of treatment for patients under the age of 56. The results of transplantation reported here, which have been achieved with conventional immunosuppressive therapy and minimum-transfusion policy, might be considered a standard against which modifications of the practice of renal transplantation can be compared.

Adolescent↗

PubMedDate not supplied

Dementia following posterior cortical atrophy--a descriptive clinical case report.

Whether posterior cortical atrophy is a distinct entity or a variant of one of the other degenerative processes continues to be debated. We describe five patients four of whom had bilateral changes of posterior cortical atrophy on the CT scan. These four had a cluster of symptoms consistent with parieto-occiptial dysfunction together with a spectrum of dementia. The fifth patient with unilateral changes had optic ataxia, apraxia of gait and dementia. Three of the five patients were heavy drinkers of alcohol but any direct causal link between alcohol and posterior cortical atrophy is tenuous but alcohol could be a consideration in lowering the threshold for dementia in conjunction with other determinants. The study revealed there is little or no difficulty in recognizing posterior cortical atrophy in the early stages and the end stages are sufficiently uniform to reduce the diagnostic uncertainty.

Journal Article↗

PubMedDate not supplied

Red cell alloantibodies produced after bone marrow transplantation.

This article describes the production of red cell alloantibodies in 13 of 150 patients after bone marrow transplantation. New alloantibodies appeared 12 days to 11 months after the transplantation. The specificities of these antibodies were anti-N, -Jka, -E-like, -Kell-like, -M, -Leb, -Hl, -H and -A1. The posttransplantation production of antibody could be due to either the transfusion of mature lymphocytes along with the marrow, the ability of the grafted immune system to produce alloantibodies, or the viable immunocompetent cells remaining despite high-dose chemotherapy and irradation.

Antibody Formation↗